Company helps providers in turbulent time

Jun. 21, 2013

David Jarrard is president and CEO of Jarrard Phillips Cate and Hancock. / Jae S. Lee / The Tennessean

David Jarrard is president and CEO of Jarrard Phillips Cate and Hancock, a Nashville-based health care public affairs firm, founded in 2006. The company recently was named one of the fastest-growing communications firms in the country. Jarrard spoke recently with Tennessean reporter Hamlet Fort about the health-care industry, effective communication in health care and public relations and what keeps him awake at night.

Most public affairs companies deal in a variety of industries, but your firm operates exclusively in health care. Why?

The industry here, of course, is significant. When you say health care is Nashvilleís business, it truly is. It would be difficult to create a shop like ours anywhere else, I believe. Itís a uniquely Nashville startup. Now our firm works around the country with hospitals that are based from one coast to the other. Like so many other health-care companies that were founded here, we started in Nashville and took advantage of the great talent, the health-care energy and entrepreneurial spirit, and have taken it around the country.

Whatís changing in the health-care industry, and how does reform affect your firmís mission?

Letís talk about health-care reform. Itís key to us, and our future, and why weíve been successful so far. For the last hundred years, the model for health care has been thereís a facility where you go to get fixed when youíre sick or hurt. Providers get paid for the volume, or the number of patients that enter the hospital. So thereís significant investment in places, and significant capital in the huge infrastructure thatís in place.

The future turns that on its head. The future is health organizations are now going to be paid for keeping people healthy and outside of the hospital. Now, going to the hospital is a cost, not a revenue generator. Itís upside down. Now the focus is going to be on wellness and health, and keeping whole populations of people well. That population health management is the future, and it changes dramatic the way people think. If youíre a CEO of a hospital, it changes the way you run your organization. If youíre a nurse, it changes the things you do, and the way youíre compensated. So we have a hundred years of history being flipped upside down.

The movement isnít happening overnight. Health-care providers have feet in both places right now. They have to be investing and preparing organizations for this future, but at the same time the money is still in the service, in getting patients in the door. Doing both is hard.

How do hospitals, health-care providers and personnel switch to this new model entirely?

They are having to live through an enormous amount of change ó and not just business model change, but a fundamental change to the industry. Itís advocating healthy lifestyles, putting more power in the hands of the primary care doctors who make sure their patients are living lives that keeps them out of their facility.

Traditionally, weíve had all disconnected pieces. Youíve got a physician here, a specialist somewhere else and a pharmacy over there. Post-operative rehab here, hospice care over there. Whatís happening now is that all these pieces are being networked together. Now your Walgreens is connected to your primary care, which is connected to your hospital, to your post-hospital, maybe connected to your home health nurse, all the way to hospice. Now itís all connected.

This transition covers every base, and the primary mission of this network is to keep you out.

Whatís the future for this new model of providing health care in America?

Even as health-care providers change what they do and how they do it, the very definitions of the words they use are changing. What is health care? What does it mean to be a physician now? Itís a change of vocabulary. Itís not just a new service or a new initiative, itís fundamental transformation. Today we have 4,000 or 5,000 hospitals around the country. I, and others who watch this closely, believe in 20 or 25 years we may have 300 to 400 health systems in the country as these groups come together to create these networks.

So you anticipate many hospital mergers and acquisitions in the future, similar to the 1990s?

Yes, but in the 1990s, there were significant amount of hospital mergers and acquisitions, but they were largely complete acquisitions ó a hospital would buy another and own it wholly. Whatís happening now, more and more weíre in the world of joint ventures, partnerships, affiliations and a variety of kinds of co-ownerships. Itís no longer one player is going to dominate; itís going to be a coalition. We believe partnership is the future of health care, for a host of reasons. Itís the best model for the best kind of care.

How does this industrial transition affect your side of the business?

This kind of transformation requires a massive amount of very thoughtful communication. You have to have a story that pulls people along through change for them to change their behavior in the way you need them to. Having a story is the most important part. Each system must create a narrative that is unique to them, and the staff, the physicians and patients who are used to this model can move to the next one. We help create that narrative.

How we communicate with one another in society is also changing. Traditional methods of communication, buying an ad, sending out a newsletter or an email ó thatís going away. Thatís not how weíre going to be communicating effectively now or in the future. So as this transformation in health care is going on, thereís a similar transformation in communications. People are expecting to be engaged ó they expect a conversation and a discussion, whether itís online, social media or in person, they expect to be able to participate in the process. People are no longer satisfied with, ďHereís your communication, absorb it and please follow.Ē The need for aggressive engagement with physicians, hospitals and their staffs, is significant. And for some organizations, itís an entirely new way of thinking.

How is your firm moving forward into that new era of effective communication?

We have three kinds of professionals in our shop. We have people who have spent their time in politics, running campaigns, speechwriters, press secretaries, etc. We have people who have spent time in journalism. Finally, we have folks who have spent careers in hospitals and the health provider world. We do it by assuming we are essentially running a political campaign, meaning all these various elements have to be connected together and moving to our cause ó we call it ďthe win.Ē

In 2011, your firm dealt in about $3 billion in merger and acquisition transactions. In 2012, it was $15 billion. Where did that growth come from?

Thatís an indication of how significant movement is in the industry. The number of transactions between hospitals is growing. Instead of hospitals acquiring other hospitals, now itís hospital systems acquiring other systems, so the size of these deals are growing and growing. Weíre very proud to be trusted by significant players when it matters, at those key turning-point moments.

What is your personal management philosophy?

If I could think of a word, it would be partnership. We run a firm that is in true partnership in this shop. We have a stable of strong and experienced leaders who are stars in their own right. My partners and I, as leaders, have to work in collaboration and a partnership with everyone here. That allows us to work in partnership with our clients. Itís an intimate operation. In a firm like ours, in a real consultancy that expects the best out of our folks, youíve got to be shoulder to shoulder.

What is your firmís philosophy in giving your clients what they need?

We believe health-care providers, whether itís a physician group, hospital or hospital system, is by nature a political organization. What we mean by that is the dynamic between doctors and nurses and payers and boards and regulators and patients is a very political interaction. We recognize, uniquely, that approaching this with a holistic, comprehensive political thinking is the smart and powerful way to do it. We bring our expertise there.

People who provide this kind of care are politically powerful. They can cause things to happen. They have political power they can use to move market share, patients, payers and to cause things to happen. But they often donít know how, or donít have the time, to think that way, to mobilize that way and to use that political power. We help them do that. We help them think about how great they are, how they can use their political strengths. Itís fun to do.

What keeps you up at night?

Itís the ability to stay current with the latest thinking and developments of whatís going on in the industry. We have a team here that is dedicated to bringing to the entire group the latest thinking, development, policy discussions. Thereís so much happening in the industry and the way people communicate. Weíre going to school every day, and our clients need it. We do that for our clients.

Do you have a major regret?

When I think about something that I shouldíve done that I didnít do, the thing that always comes to mind is starting this firm sooner. The opportunity here is so strong, that this is a step that couldíve been taken many years before we actually did it.